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Many questions about the all-payer model remain. How will the state hold the ACO accountable for giving patients the care they need? What recourse will patients have if their ACO providers deny them services or give them sub-standard care? Will the state regulate the ACO like it does commercial insurers? Will the inner workings of the ACO be transparent to the public? Will consumers have a voice in how the ACO is run? Will we know whether or not the system is improving the health of Vermonters?

Patient and community interests should be central to the design and implementation of any new health care system. Advocates and members of the public must insist that policymakers translate these unanswered questions about the all-payer model into robust consumer protections.